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Injections-that is using J1040

  1. #1
    Default Injections-that is using J1040
    Medical Coding Books
    We have a clinic that is using J1040 which is an 80 mg methylprednisolone acetate injection, but they only give 40 mgs. They do not have the J1030 vials which are 40 mg doses in house. My question is that I want to bill 0.5 units and am having some issues. Does anyone else bill this way?

  2. #2
    You can't bill a 0.5 in the units.
    Herbie W Lorona Jr., CPC, CPC-H

  3. #3
    Sioux Falls South Dakota
    Quote Originally Posted by Herbie Loroña View Post
    You can't bill a 0.5 in the units.
    Are these multi-dose vials or single-dose vials? If they are multi-dose, you would then bill the J1030 with one unit, as they are going to use the rest of the vial for someone else. If, however, they are single-dose, you would bill for the entire vial, as the rest is wasted (also one unit).

    If, however, your office routinely does only 40 mg, and the vials they order are single dose, they really should be ordering the 40 mg vials, rather than continually billing insurance for the wastage.

    Most of the depo our offices use comes in multi-dose vials; we then bill whatever was really given (20, 30, 40, etc.)
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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